Diversity Management In The Workplace: Beyond Compliance

or just as hum an beings. In this regardFitzgerald (1997:3) warns that ‘‘therem ust .b e understanding and appre ciation o f fu n d a m en ta l d iffe re n c e s'between groups - cultural or other wise - with an emphasis on diversity.But there m ust also be recognition o ffu n d a m e n ta l sim ilarities, ’ culturaluniversals that link us to a commonhumanityImportantly however, we cannot denythat "cultural background is one o fthe prim ary sources o f identity. It isthe source fo r a great deal ofself-definition, expression and sense o f groupbelonging” (Ayton-Shenker 1995: 1).Understanding and respecting culturaldiversity in the workplace, thereforemust o f necessity be prem ised on theunderstanding that people do belongto groups, and that to a large extent,their identities are defined by their tra ditional culture. But as noted by oth ers, cross-cutting social variables suchas education, social class, level o f mod ernization, language group, regionaland political differences (de Haas 1990;cited in Human 1996:53) as well as “eth nic aw areness and perceived d iffer ences o f gender or sexual orientation”(Fitzgerald, 1997, p. 3) create an ongo ing process o f interaction and intermin gling o f cultures leading to changedcultural id en tities (A yton-S henker,1995:1).Managing cultural diversity in the clini cal setting must focus not on collec tives but on valuing individuals andcreating environm ents conducive tothe maximizing o f individual develop m ent and potential, irrespective o fgroup membership. It is not about af firmative action or equal opportunitiessimple aimed at getting the numbers‘rig h t’. M anaging diversity is aboutaccepting that all employees, profes sional and non-professional, from thecleaning staff to the ch ief executiveofficer can contribute positively to wards the realization o f the institution’smission and goals. In a clinical settingthe quality o f patient outcom es is themost critical organizational goal. Thequality o f patient outcomes, however,is as m uch the function o f the qualityo f interpersonal working relationshipso f the staff as well as the quality o fvocational and/or professional exper tise. It is the responsibility o f seniormanagem ent and all line managers tocreate “a culture o f mutual respect andthe realisation that valuing each em ployee’s differences can bring strengthand synergy to groups, teams, depart ments and ultimately the organizationas a whole” (CIPD 2005: 11).Understanding anddealing with challenges ofcultural diversityM ost literature on managing culturaldiversity emanates from private organi zations. It is acknowledged that SouthAfrica is rich in both its private andpublic health sector. Public and privatemetropolitan clinical settings experiencesim ilar diversity challenges. Much o fthe private industry literature on diver sity m anagem ent exalts the benefits o fa diverse w orkforce. These benefitscentre on the belief that individual dif ferences create the potential for a morecreative and different way o f thinkingabout organizational issues and thusshould lead to innovative solutions toroutine problems. Additionally, withinthe clinical setting context, it is be lieved that the diverse patient popula tion would be better served by a di verse staff. There is the danger how ever, o f romanticizing an extremely com plex and dem anding process, which asnoted by Tshikwatamba (2003:36) “de sp ite th eir advantages in the w orkp la c e . differences are sometimes thesource o f considerable hostility anddisagreementsThat cultural differences and religiousbeliefs have been the cause o f muchhostility and human suffering globally,is a m atter o f public knowledge. Theclinical setting is but a small aspect o fthe world in which we live and work.Within the clinical environment, culturaldifferences can be found in both tradi tional cultures and the ‘new ’ culturalid e n titie s re s u ltin g fro m thesocialization and inculcation processese n c o u n te re d in th e p ro fe s s io n a lschools that produce those who popu late the clinical setting. So then, whatare some o f the challenges that are as sociated with managing diversity in theclinical setting? The CIPD (2005: 6-7)identifies a num ber o f factors that im pact on the management o f a workforce.Those which are relevant to this paperinclude (a) changes in the social, andlegal landscape, (b) the psychologicalcontract, and (c) cultural and organiza 6Curationis June 2009tional changes.Changes in the Social and LegalLandscapeAffirmative action and employmentequity are legislated mechanisms whichaim to create a fully inclusive work en vironment in South Africa. “Employ ers have been fo rce d by law to accel erate the hiring o f a m ore diverseworkforce and to remove the barriersto employment progress fo r previouslydisadvantaged groups ” (Sacht, n.d.: 1).No industry, including the clinical set ting, is excluded from the legal require ment to ensure a demographically di verse workforce. In a country with ahistory o f legal racial segregation o f theworkplace, the challenge is to ensurethat institutions go beyond complianceand create environments that are con ducive to effective contribution o f allemployees toward the realization o f theinstitution’s mission and goals.Desegregation o f health care settingswith the concomitant inclusion o f allSouth A frican population groups inin stitu tio n s p re v io u sly seg reg atedalong racial lines, for access and staff ing, presents a uniquely South Africanchallenge for diversity management.Many health care professionals, usedto work with colleagues and providecare to patients whose way o f life wassim ilar to theirs and who spoke thesame language. Suddenly these work ers are faced with a diverse hospitalpopulation (patients and staff) whoseway o f life is markedly different fromthe d o m in an t W estern h ealth caremodel o f our health care settings. Forexample, there are patients who do notspeak the same language as the pro fessionals that care for them. The re sult is that most health care profession als are caring for patients whose com plex needs are very difficult, if not im possible, to understand or recognize.The professionals are w orking withcolleagues w hose individual differ ences, beyond the stereotypical clas sifications they grew up with as well asthose learned at medical and/or nurs ing school, continue to be a mystery.Hiring more people from the previouslydisadvantaged groups w ill not andcannot o f itself ensure that these di verse groups o f people work togethereffectively (Human 1996:46; Sacht n.d.:1). Strategic and concerted efforts must

be made to ensure that all employeeshave a fair and equitable chance to com pete for the few promotional positions.Although a number o f institutions haveinitiated diversity management training,often in the form o f once-off w ork shops, concerted and ongoing effortsat education and training are not evi dent. Perhaps, because o f tight budg ets, and cost cutting within a financiallystretched health care environm ent,“the extra effort, which focuses on di versity training and interpersonal learn ing, is still viewed as an optional extra”(Sacht n.d.: 1). Yet, still it could be that,health care organizations, having sat isfied themselves that they have man aged to get the demographics “correct”,feci that th e ir job is done because th estatistics shows that they comply withlegislation.W ithin the health care industry, re search and academic inquiry have fo cused mainly on cultural competcnccas this relates to patient care. Little, ifany work has been done on the inter personal relations and the meaning o fdiversity among the employees. Moreimportantly, South African researchers,managers and scholars in the healthcare industry, are dcafeningly silentabout the state o f managing diversityin both the public and the private healthsector. A study conducted by Aries(2004: 172-180) involving senior m an agers, line m anagers, p atien ts andfrontline workers in six hospitals in theUnited States o f America revealed thatalthou g h cu ltu ral com petence wasviewed as critical for patient care, un derstanding its m eaning was d eter mined by one’s role. For instance, Ar ies reported that senior managers weresatisfied that the hospital took culturalcompetence seriously because mostmaterials such as procedure manualshad been translated into the most com mon languages used in the region,translation for patients was availablewhen needed, and culturally diverses ta ff w as e m p lo y ed . P a tie n ts andfrontline w orkers however, believedthat cultural biases were seen as em bedded in the day -to - day function ing o f the hospital.Pointedly, “senior managers were mostconcerned with developing positiverelations with communities surround ing the hospitals, creating a physicalenvironm ent that was accommodatingto p a tie n ts' cultural beliefs and prac tices, adapting hospital policies to beculturally responsive, hiring a diverseworkforce that paralleled that o f thecommunities served " (Aries 2004: 174).Line managers had total responsibilityfor interpreting and implementing thehospitals’ policies on cultural diversityand competence and saw any conflictsam ong sta ff as p ersonality relatedrather than culture based. Frontlineworkers “fe lt that racial and culturalstereotyping existed throughout thehospital and that it negatively affectedthe work environment ” (Aries 2004:178).The Psychological ContractT h e C IP D (2005: 7) defines th e p sy c h o logical contract as the unwritten con tract between the individual and theemployer. The changing workplace en vironment and the diminishing oppor tunities for jobs for life has led to a situ ation in which employees are lookingfor short-term rather than long-term re wards. According to the CIPD, per sonal development and work-life bal ance are high on today’s em ployees’expectations. Employers who do notrecognize this arc faced with high s

when last I was in the clinical setting. I accepted this task on the assumption that the clinical setting in South Africa at least, presents similar yet particular challenges to diversity management as any other workplace. Secondly, the complexity of the concept of culture, and its inextricable association wi